Evaluating the impact of a Cumulative Impact Zone Policy to reduce alcohol-related harms in Islington Local Authority
SPHR-LSH-PES-CIZ
06 March 2017
01 May 2014
31 October 2016
30 months
Alcohol, alcohol harms, policy, crime, hospital admissions, retail sales.
Karen Lock, Professor of Public Health, London School of Hygiene and Tropical Medicine (LSHTM)
N/A
Following introduction of a Cumulative Impact Policy by the London Borough of Islington in 2013, an evaluation was conducted by the School for Public Health Research team at the London School of Hygiene and Tropical Medicine (http://sphr.lshtm.ac.uk).
The aim of the evaluation was to understand how, and to what extent, the Cumulative Impact Policy had affected alcohol licencing decisions, alcohol availability and alcohol-related harms (including crime and health), in order to inform the review of Licencing Policy in the London Borough of Islington (2017-2022).
We extended the end date of the project so that we could continue the quantitative data collection and extend the time period included in the time series analysis.
We examined the impact of the introduction of the new cumulative impact zones across Islington in January 2013 on a range of outcomes including:
We used a time series approach to assess both the immediate impacts (i.e. short term changes at the time of CIP introduction) and impacts over the longer term (i.e. a relative change comparing trends before and after the introduction of CIP - from 2008 to 2016) in CIZ and non CIZ.
The introduction of CIP in Islington has not led to any significant changes in the total number of alcohol licenses submitted in the long term. Nor did introduction of the CIP displace licence applications from CIZ to non CIZ. Our ITS analysis indicated that the immediate impact of CIP introduction on rates of successful licence applications was a statistically significant drop in success rates in both CIZ (-28.55%, 95% CIs: -39.68 to -15.36) and non CIZ (-24.03%, 95% CIs: -41.90 to -0.65). This was followed by statistically significant longer term increases in success rates in both CIZ and non-CIZ areas.
This indicates that CIP has not been a barrier to gaining a licence to sell alcohol in Islington and suggests successful businesses have been able to adapt to comply with the current Licencing Strategy requirements.
Findings on trading and closing times are consistent with the current licencing policy objectives that aims to reduce temporal alcohol availability by removing 24hr licensing, reducing after midnight opening and reducing early trading.
There were statistically significant longer term decreases observed in the average weekly duration of trading hours after CIP introduction, with the reductions in trading hours post CIP being more pronounced in on-license applications and in non CIZ.
The rates of licence applications with earlier closing times (ie closing times before midnight on Friday and Saturday nights) increased before 2013, but showed a statistically significant decrease after CIP introduction in CIZ only. This could be explained by market saturation for later night licenses before CIP was introduced and the fact that newer licenses would have to be agreed on shorter opening times consistent with the new Licencing Strategy.
Between December 2010 and April 2016 there were a total of 194,003 crime incidents recorded in Islington, of which 52,754 were anti-social behavior incidents. Rates of total crime and anti social behaviour decreased overall between 2011 and 2016. Following CIP introduction, the evaluation found a significant short term decrease in overall crime rates in both CIZ and non CIZ (but no immediate change in anti social behaviour rates). Comparing trends before and after CIP introduction, total crime and anti social behaviour declined at a slower rate after CIP introduction.
Between April 2008 and March 2016 there were a total of 20,250 alcohol-related ambulance call-outs in the London Borough of Islington. Overall there was a decreasing trend in alcohol-related ambulance call outs between 2011 and 2016 in both CIZ and non CIZ. Although alcohol related ambulance call outs decreased after CIP introduction, we found no statistically significant immediate and longer term impact related to CIP introduction.
We analysed a small sample of retail sales data for Islington, limited to a 10% sample of on-licence premises (mainly limited to pubs and bars).
Overall between 2010 and 2016 there was an increasing trend in total weekly average per premise alcohol sales value (£). When comparing long term trends statistically before and after the introduction of CIP, the impact of CIP was a small, non statistically significant increase in CIZ, and a small statistically significant decrease in non CIZ for weekly average per premise alcohol sales (£).
For total average weekly units of alcohol sold per premise, there was a small, statistically significant increase in units of alcohol sold in both CIZ and non CIZ long term after the CIP introduction, although the increase was much smaller in non CIZ.
We found little evidence of any impact on the average weekly quantity of alcohol products sold per premise in CIZ. In contrast, there were small, statistically significant decreases in weekly quantity of alcohol products sold per premise in non CIZ, both immediately after CIP introduction and longer term.
The findings for retail sales data should be interpreted with caution due to the small numbers and selective nature of the dataset but it seems to suggest that CIP introduction has had little impact economically on alcohol retail businesses in Islington.
The results of the evaluation show that the Licencing Strategy overall, and the Cumulative Impact Policy specifically, have been broadly effective. The implementation of the strategy has met the objectives of reducing crime, anti-social behaviour and alcohol-related ambulance call outs, reducing the rate of successful applications for off-licences, reducing the average weekly trading times of alcohol licences granted.
Concurrently, three years after CIP introduction there have actually been increases in rates of alcohol licences granted overall. There also appears to be little or no impact on alcohol retail sales volume and sales revenues since 2013.
This evaluation appears to show that the London Borough of Islington’s Licencing Strategy and the CIP have reduced alcohol related harms without negatively impacting on the overall night-time economy in Islington and the ability of alcohol retailers to operate if they meet the conditions required.
Cumulative impact policies (CIPs) are widely used in UK local government to help regulate alcohol markets in localities characterised by high density of outlets and high rates of alcohol related harms. CIPs have been advocated as a means of protecting health by controlling or limiting alcohol availability.
We used a comparative qualitative case study approach to assess how CIPs were implemented in Islington, and how implementation varied across different localities, what they are intended to achieve, and the implications for local-level alcohol availability. In depth semi structured interviews were conducted with 48 practitioners from licencing, police, community safety and public health in 5 local government authorities across England.
We found that the CIPs in the 5 areas varied greatly in terms of aims, health focus and scale of implementation. However, they shared some common functions around influencing the types and managerial practices of alcohol outlets in specific neighbourhoods without reducing outlet density.
The assumption of those implementing CIP is not that they will reduce alcohol outlet density, but will enable licencing of types of premises that will lead to alcohol harm-reduction. This needs to be quantitatively tested.
Two outputs with detailed results:
Grace D, Egan M, Lock K. Examining local processes when applying a cumulative impact policy to address harms of alcohol outlet density Health & Place. 2016. Volume 40. pp. 76-82 doi:10.1016/j.healthplace.2016.05.005
Egan M, Brennan A, Buykx P, Vocht Fd, Gavens L, Grace D, Halliday E, Hickman M, Holt V, Mooney J D, Lock K. Local policies to tackle a national problem: Comparative qualitative case studies of an English local authority alcohol availability intervention Health & Place. 2016. Volume 41, September 2016, Pages 11–18. doi:10.1016/j.healthplace.2016.06.007
The main objectives were to identify and characterise the drinking spaces of the local alcohol environment, and how this may differ between CIZ and non CIZ in Islington
Adopting a qualitative case study approach to data collection, 39 licensed premises were visited in the London Borough of Islington, and on-site observations carried out between the hours of 12pm and 6pm using a semi-structured observation guide. Observations were written up into detailed fieldnotes, uploaded to NVivo and subject to a thematic analysis. Additionally, informal interviews were conducted with some staff selling alcohol and some consumers in a variety of venues.
The daytime on-premises alcohol environment was characterised by two main trends: the decline of traditional pubs and a proliferation of hybrid establishments in which alcohol was framed as part of a suite of attractions (including food, coffee, the arts). The consumption trends that the later personify have been regarded as positive in terms of public health, crime and safety. Less vertical drinking and more family-friendly licensed premises are hypothesised as contributing to a reduction in excessive consumption and alcohol related harms, and are part of current local Licencing strategy. However, hybrid establishments could also help introduce drinking within contexts, times and behaviours where it was not previously present.
CIPs which aim to reduce alcohol harms appear to be working in parallel with local gentrification trends. While alcohol policies, such as CIP might not have achieved, nor possibly were intended to achieve, a substantial curbing of the ‘alcohol economy’ it does appear that they have helped to reshape the daytime alcohol environment in line with the broader processes of gentrification and the new consumer demands it brings to the area. This reshaping appears to be discouraging practices of ‘determined drunkenness’ in daytime spaces by framing alcohol as a possible ‘treat’ within a range of products on offer in hybrid venues. Conversely, these changes may also risk negative impacts in the longer term as they have the potential to ‘stretch’ socially acceptable alcohol practices, and feed into current alcohol industry strategies of promoting ‘new moments’ ; new places, times and contexts in which consumers can drink. These possible ‘unintended consequences’ require further research.
Islington has one of the highest densities of pubs, bars, clubs and off licences in the country and second highest in London after the City of Westminster (ie the West End). Alcohol consumption has been identified as a major factor behind violent crime and disorder in the borough with consequences to victims, businesses and local communities. Islington’s residents also suffer from high levels of alcohol-related ill health and early deaths.
The Licensing Act 2003 enables English local authorities to implement Cumulative Impact Policies (CIPs). CIPs strengthen the powers of local authorities to reject licence applications for retail alcohol sales in cumulative impact zones (CIZs), where adverse effects of high alcohol availability can be demonstrated.
This evaluation focused on the introduction of Cumulative Impact Zones across the London Borough of Islington in January 2013, but also took into account concurrent implementation of other aspects of the current Alcohol Licencing Strategy (2013-2017) including a focus on reducing premise trading hours, reducing off-licence availability, and improving the quality of alcohol retailing overall.
The policymakers and practitioners that implemented the CIP did not intend for the policy to reduce the number (or density) of premises selling alcohol in Islington, but aimed to reduce the impact of alcohol related harms in the Borough.
The results of the evaluation show that the Licencing Strategy overall, and the Cumulative Impact Policy specifically, have been broadly effective. The implementation of the strategy has met the objectives of reducing crime, anti-social behaviour and alcohol-related ambulance call outs, reducing the rate of successful applications for off-licences, reducing the average weekly trading times of alcohol licences granted.
Concurrently, three years after CIP introduction there have actually been increases in rates of alcohol licences granted overall. There also appears to be little or no impact on alcohol retail sales volume and sales revenues since 2013.
This evaluation appears to show that the London Borough of Islington’s Licencing Strategy and the CIP have reduced alcohol related harms without negatively impacting on the overall night-time economy in Islington and the ability of alcohol retailers to operate if they meet the conditions required.
The practitioner involvement from the 3 project leads at the London Borough of Islington was an integral part of the project development and delivery from start to end. The 3 LA partners contributed from the initial application to the PHPES scheme, through designing methods, facilitating data collection and contacts for data collection, providing quantitative data in the required formats, and helping find solutions to data. There were no problems, and the practitioners were also happy for us to have a 6 month project extension to improve some additional data analysis, as this still fitted into their policy review time line.
The practitioner involvement from the 3 project leads at the London Borough of Islington was a positive part of the project collaboration, and an integral and essential part of the project development and delivery throughout. We had a pre-existing research relationship with the practitioners involved in this project, and so this probably helped ensure that we had no issues with smoothing out any data, methodological or delivery issues emerging in the application of the project plan. We were able to communicate well and adapt the project with invaluable practitioner involvement at key stages throughout the project. We did not have explicit public involvement in this project, as Islington Council has had a public consultation into the alcohol policy we then evaluated.
This is the first quantitative, and mixed methods, evaluation of a cumulative impact policy in England. CIPs are now widely implemented across England and this should provide important evidence for those councils developing or expanding CIPs.
This project was funded by the National Institute for Health Research School for Public Health Research (SPHR-LSH-PES-CIZ)
The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR School for Public Health Research, NIHR, NHS or the Department of Health.
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